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What is the most appropriate instumental evaluation to assess infant pharyngeal swallow function withour radiation exposure
FEES- Fiberoptic Endoscopic Evaluation of Swallowing
What phase of swallowing in infants involved bolus transfer from the tongue to the pharynx
Oral phase
What is a behavior based swallowing screening tool
Mealtime Behavioral Questionnaire
A child frequently spits out food and gags on textured solids. What phase is most likely affected
Oral Preparatory Phase
What is a key difference in infant anatomy that supports safe swallowing compared to older children
Higher Laryngeal Position
What condition is most likely to disrupt suck-swallow-breathe coordination in a premature infant
Nasal Congestion
What is a non-instrumental assessment tool used to evaluate oral feeding skills in infants
Pediatric Swallowing Assessment Scale
What is a common feeding sign in infants with laryngomalacia
Stridor During Feeding
What reflex supports nipple finding in newborns
Rooting
What is the first step in evaluating pediatric feeding and swallowing difficulties
Review Medical and Developmental History
What contributes to efficient sucking in a newborn
Buccal Fat Pads
In infants, the swallow is triggered at which anatomical landmark
Anterior Faucial Pillars
A 2 month old infant is bottle fed and takes over 45 minutes to finish feeds. What is the best recommendation
Refer for feeding and swallowing assessment
T/F: The oral preparatory phase in infants includes only voluntary movements
False
T/F: The pharyngeal phase of swallowing in infants is completely under voluntary control
False
T/F: A hyperactive gag reflex in toddlers is always a normal developmental finding
False
T/F: Drooling beyond 24 months may suggest oral motor immaturity or dysfunction
True
T/F: Coughing while drinking from a bottle in an infant can be a sign of aspiration
True
T/F: Silent aspiration is difficult to detect without instrumental assessment
True
T/F: Poor coordination of suck swallow breathe is frequently seen in premature infants
True
T/F: A tongue thrust reflex persisting past infancy may affect later speech and feeding development
True
T/F: Parental feeding practices and mealtime routines are not relevant to pediatric dysphagia assessments
False
T/F: Feeding and swallowing difficulties in infants can affect growth, hydration, and quality of life
True
Rooting Reflex
Helps infant locate nipple
Suck Reflex
Draws liquid into the mouth
Gag Reflex
Prevents entry of material into the throat
Swallow Reflex
Transfers bolus from the oral cavity
Oral Motor Assessment Scale
Evaluates oral movement during feeding
Pediatric Eating Assessment Tool
Screens for feeding and swallowing difficulties
Mealtime Behavioral Questionnaire
Captures behavior during meals
Fiberoptic Endoscopic Evaluation of Swallowing
Visualizes pharyngeal and laryngeal function
Cranial Nerve V (Trigeminal)
Chewing and Jaw Stability
Cranial Nerve VII (Facial)
Lip closure and facial movement
Cranial Nerve IX (Glossopharyngeal)
Gag reflex and taste
Cranial Nerve XII (Hypoglossal)
Gag reflex and taste
Velum
Seals Nasopharynx
Larynx
Protects airway during swallowing
Tongue
Directs bolus and supports suction
Buccal Fat Pads
Provides cheek stability during feedings
Cerebral Palsy
Poor oral tone and limited control
Prematurity
Poor coordination of suck-swallow-breathe
Down Syndrome
Large tongue, hypotonia
Autism Spectrum Disorder
Sensory Based Food Aversions
Wet Vocal Quality
Penetration or aspiration
Coughing During Feeding
Post-Swallow Residue
Arching and Crying
Gastroesophageal Reflux
Nasal Regurgitation
Velopharyngeal Dysfunction
Begins Purees
4-6 Months
When do we transitions to solids
6-9 Months
When can children drink from an open cup
9-12 Months
Uses spoon independently
12-18 Months
Rooting Reflex Age
3-6 Months
Suck Reflex Age
6-9 Months
Phasic Bite Reflex Age
4-6 Months
Transverse Tongue Reflex Age
9-12 Months
Signs of a Wet Voice After Meals Test suggest what test to be used…
Modified Barium Swallow Study
Frequent Coughing on Thin Liquids suggests
Suspected Silent Aspiration
Difficulty Latching at Breast
Referral to Lactation Consultant
Suspected Silent Aspiration, what test used?
FEES and MBSS may indicate
Feeding behavior: Turning Head Away
Avoidance due to stress
Holding Food In Mouth may suggest a
Oral-motor delay
Gagging without Oral Input
Hypersensitivity or reflux
Refusing to Sit at Table
Sensory-Based Feeding Aversion
Infant arches during bottle
Reflux Evaluation
Parent reposts child refuses all meats, clinical response ….
Behavioral Feeding Screen
Parent reports Gulping Sounds During Bottle, clinical response…
Instrumental Assessment Referral
Toddler Feeds Longer Than 45 Minutes
Oral Phase Evaluation
The purpose of Side Lying Bottle Feeding is…
Reduce Fatigue
External Pacing
Improve Coordination
Flavored Boluses
Increased Oral Sensory Input
Feeding strategies: Slow Flow Nipples
Flow Regulation
Care giver support strategies: Provide Chaining Chart
Encourage Variety
Care giver support: Teach Paced Feeding
Improve Coordination
Care giver support: Demonstrate Oral Massage
Strengthen Oral Patterns
Care giver support: Video Recorded Mealtime
Support Home Carryover
What feeding strategy is commonly used for preterm infants to help organize sucking patterns
Non-Nutritive Sucking
What is a potential benefit of using a side lying feeding position in infants
Reduces fatigue and improves coordination
What treatment strategy is commonly used with infants with gastroesophageal reflux aka GERD
Using upright feeding posture
What intervention is most appropriate for an infant with poor lip closure during feeding
Lip-Strengthening Exercises
What is the most appropriate technique for improving bolus propulsion in children with weak tongue muscles
Tongue Restistance Exercises
What is the primary purpose of non-nutritive sucking
Facilitate oral motor development and readiness to feed
What is true about infant driven feeding programs
Support cue based feeding to promote safety and comfort
What would be part of an oral stimulation program for a child with reduced oral tone
Pressure brushing and jaw tapping
What is a common modification for a child with delayed swallow initiation
Introducing sour bolus stimuli
What is a key characteristic of food chaining
Gradually introducing new foods based on accepted preferences
What is the rationale of using thickened liquids in pediatric dysphagia management
Slow bolus flow and reduce aspiration risk
What best describes the purpose of a spoon placement technique in oral motor feeding therapy
Improve bolus control and lip closure
What team member is most responsible for positioning and adaptive equipment during pediatric mealtimes
Occupational Therapist
What treatment approach emphasizes behavioral reinforcement during pediatric feeding therapy
The sequential oral sensory (SOS) approach
What technique is used to increase swallow initiation through sensory input
Thermal tactile stimulation
What would be an appropriate intervention for a toddler with food refusal and tantrums at meals
Providing distraction free mealtime environment
What feeding posture is recommended for an infant with laryngeal penetration on thin liquid
Side lying
T/F: Children with down syndrome may benefit from thickened liquids due to hypotonia
True
T/F: Texture progression is part of most pediatric feeding therapy programs
True
T/F: A child's sensory processing profile should be considered in feeding treatment planning
True
T/F: Children with autism spectrum disorder often benefit from rigid mealtime routines only
False
T/F: Oral aversion can be addressed using graded exposure to sensory input
True
T/F: Children with cleft palate may need special bottle systems and positioning
True
T/F: It is appropriate to work on feeding skills even if a child is currently tube-fed
True
T/F: External pacing may support infants who cannot coordinate sucking and breathing
True